New vitamin D recommendations

By
Rob Stein

Despite mounting pressure to urge many Americans to sharply boost their vitamin D levels, new official recommendations are not advocating a huge increase in the amount of the "sunshine vitamin" that people get.

The United States and Canada asked the Institute of Medicine, which is part of the National Academy of Sciences, to update the official vitamin D recommendations for the first time since 1997. A 14-member expert committee convened for the task concluded that most Americans and Canadians up to age 70 need no more than 600 international units of vitamin D per day. The elderly may need as much as 800, the committee concluded.

Previously, experts called for children and younger adults get 200 international units a day, adults ages 50 to 70 get 400 and the elderly to get 600. But a flurry of research indicating that vitamin D may have a dizzying array of health benefits, and that many people may have insufficient levels, had reignited an intense debate over whether federal guidelines were outdated, leaving millions unnecessarily vulnerable to heart disease, cancer, diabetes, the flu and other ailments. Some doctors have begun routinely testing their patients' vitamin D levels and recommending that people should routinely consume 2,000 or 3,000 international units a day. Sales of vitamin D supplements have increased sharply in recent years.

Vitamin D may no longer be called the sunshine vitamin. (Jupiter Images)

After reviewing nearly 1,000 published studies along with testimony from scientists and others, the expert committee concluded that vitamin D and calcium play an important role in creating and maintaining strong bones. But the committee concluded that while further research was warranted into vitamin D's role in other health issues, at this point the evidence is mixed and inconclusive. The committee noted that other nutrients, such as vitamin E, were thought to have a host of health benefits, an idea which was later disproved and in some cases found to be dangerous.

So the committee recommended that 600 international units a day met the need for almost everyone in the United States and Canada, though people age 71 and older may need as much as 800. The committee also concluded that available evidence does not indicate there are widespread deficiencies, as some have suggested, requiring routine screening.

In addition, contrary to what some vitamin D proponents have been urging, the committee did not recommend people increase their sun exposure, citing concerns about skin cancer.

Scientists have long known that vitamin D is a vital nutrient that the skin produces when hit by sunlight. The amount varies, depending on where the person lives, skin pigment, age and other factors. With people spending more time indoors and covering up and using sunblock when they do go outside, the amount of vitamin D people create in their bodies has been thought to be falling.

But the committee concluded that most people can get sufficient vitamin D from their diets or by taking vitamin D supplements. Milk and other foods are fortified with vitamin D and it occurs naturally in others, such as fatty fish.

The recommendations disappointed many proponents of higher vitamin D intakes. Michael Holick of Boston University, one of the leading proponents of the supposed benefits of vitamin D, said he was pleased that the committee recommended higher levels than the previous guidelines. But Holick and others argue that there is more than enough evidence to support taking much more on a routine basis to reduce the risk for a host of health problems. Holick, for example, says he personally takes 3,000 international units a day and advises his patients to do so as well. Holick noted that the committee increased the upper limit of what was considered a safe level of vitamin D to 4,000 for adults.

When the story for the need for vitamin D initially surfaced, research had found African American children suffered this deficiency. My doctor prescribed vitamin D after finding deficiency via blood test. This article addresses neither AA children propensity for this deficiency nor does it address persons diagnoised with this defienciency. Sad.

When the story for the need for vitamin D initially surfaced, research had found African American children suffered this deficiency. My doctor prescribed vitamin D after finding deficiency via blood test. This article addresses neither AA children propensity for this deficiency nor does it address persons diagnoised with this deficiency. Sad.

As a Republican, I urge Americans to reject this so-called science and rely on innuendo, rumor and self-appointed "expert" charlatans to make these important decisions. Our constituents in the supplement industry are depending on you to continue your ignorant and uninformed ways.

Remember when there was a hue and cry that eggs were just terrible for you only later for health officials to say they're a very important source of protein? "Michael Holick of Boston University, one of the leading proponents of the supposed benefits of vitamin D, said he was pleased that the committee recommended higher levels than the previous guidelines".....wonder how much income he derives from the pharmaceutical industry???? My doctor has told me about him and other doctors "serving on these panels" and if the doctors don't agree with what is proposed by "higher ups", they're dropped from the panel. Hmmmmm........and they call this science? Folks, wake up! Remember, doctors bury their mistakes!

I HAVE NO IDEA WHY AND I AM USUALLY NOT INTO CONSPIRICY, BUT, FOR SOME REASON OTHER THEN OUR HEALTH THE GOVERNMENT WANTS US TO STAY OUT OF THE SUN......I DO NOT KNOW ABOUT VITAMIN D, BUT I DO KNOW BEING IN THE SUN MAKES ME FEEL GOOD. IS A DEPRESSED NATION EASIER TO CONTROL ???????? THE WHOLE STAY OUT OF THE SUN PROPAGANDA IS TOTAL B.S.

At least people are waking up and realizing that they can not rely on the government for accurate information. People are taking more resonsibility for their own health and seeking other sources of advice. Looks like the trend will finally result in the government totally being ignored.

1) Show me a case of Vitamin D overdose in the US? If the first half hour of exposure to sun makes your body produce 15,000 IU Vitamin D then obviously we all should be poisoned by Vitamin D - not happening.

when I was first tested I was at 12, I reached a level of 36 about six months ago... taking a 2000 daily supplement for about 18 months.

me and my doctor are doing an experiment, after reaching the 36 level... we lowered my supplement level to 1000 per day in a few weeks I will be tested again... and see how that change effects the blood level....

after the experiment is over I plan on bringing my level up to 60.. the point at which our body starts to store vitamin D for future use..

The truth is that only a very few - but very vocal - proponents (physicians) have been insisting that "low" vitamin D levels (& low intakes) have *caused* (or contributed to) a variety of chronic diseases, when there is actually almost no strong evidence to support this view (only associative - rather than cause & effect -relationships). But that's good enough for virtually the entire online media (& health writers), who have constantly driven this "story" so that now everyone "knows" that low vit. D causes cancer, heart disease, etc. Except it likely doesn't. But it's such a compelling story because it's very easy for the masses (& journalists & non-medical people) to understand, & it's a simple solution for a variety of complex (health) problems. Online media decision makers / editors / gatekeepers & health journalists need to better appreciate that physicians & medical researchers - even those with the most impressive credentials associated with leading medical & academic institutions - often have significant biases (just like other people), and may become strongly fixated on an idea that lacks scientific validity (& then look for scientific backup of that idea). Please do us all a favor: Do more critical thinking and research on your own before jumping on the media bandwagon & rushing to publish.

Noone is getting rich off Vitamin D sales. A vitamin can't be patented, so competition keeps prices low. That's a major reason there have been so few studies -- noone has a financial incentive to boost demand.

A supply of Vitamin D costs $10 per YEAR. It's simply not a lucrative business.

Comments about Vitamin D being a money-hungry conspiracy are ignorant.

My blood tests register my Vitamin D level at 18. That's not high, and I get all kinds of urgent panicky marks on my lab results by the doctor. So I think that means I should be taking Vitamin D supplements, but this report is unclear about what to do in my situation. In fact, this article does not even mention Vitamin D levels in the blood at all. What kind of credence are people who are concerned about this kind of thing supposed to put in it? If it's valid, then make it obviously valid. I've heard the report is 1,000 pages long.

I just had my Vitamin D level tested last month, after spending at least an hour a day 5 days weekly this summer in the NC sunshine (water aerobics outdoors). I was still slightly below my physician's recommended optimal range of 70-100 ng/mL, and so now my daily intake via supplements has been increased to 10000 IUs daily. The vitamin D I take has helped to cure my osteopenia, has improved my mood (especially in the winter) and helped to modulate my chronic back pain. The levels listed in this article seem to be woefully inadequate.

Many women who think they have a calcium producing problem i.e. not enough calcium to make strong bones after menopause actually have a vit. D deficiency. Women should be tested to see if they are D deficient BEFORE being prescribed a calcium supplement which can have huge side-effects.

This article does not address any of this and is only about what the general "you" should take as a daily dose---most of which you would get if you ate fresh green leaf vegs--spinach, lettuces (other than iceberg) etc. and nuts.

It's good journalism to ignore a very important reason to take D for women.....

This report does not take into account northern latitudes, they can say what they want about getting enough calcium in your diet, I know many things are fortified now. However, being a small women, there is no way I can eat enough daily of these items, and not become obese! I live in the Seattle area, I work outside all summer in my shorts and bandeau top getting a "tan", and as a by product a pretty yard. Three years ago had my vitamin d 3 blood level checked in Jan......and I was at 8.........It seems my three months of soaking up the vitamin d from the sun will not protect me thru the winter months............I can't believe the report that says walk from your car to your job and get enough vitamin d, around here, you get wet!! This report also doesn't take into account aftrican american people who have trouble synthesizing enough vitamin d, or obese people who require more vitamin d as the fat cells soak up the vitamin not allowing it into the blood stream. This report maybe fine for those who live in the sunny south, it is not appropriate for those of us who live farther north!! This report also honed in on bone health......there are 700 recepters for vitamin d in our bodies, not just in your bones. I will continue taking my 2000 units a day, have noticed I am much healthier, I also take calcium, twice a day. Really, how am I suppossed to get enough calcium on a 1500 calorie day, which at my size is what I can eat without gaining weight? In the practical world, this study stinks! Thanks for allowing me my say........

This report does not take into account northern latitudes, they can say what they want about getting enough calcium in your diet, I know many things are fortified now. However, being a small women, there is no way I can eat enough daily of these items, and not become obese! I live in the Seattle area, I work outside all summer in my shorts and bandeau top getting a "tan", and as a by product a pretty yard. Three years ago had my vitamin d 3 blood level checked in Jan......and I was at 8.........It seems my three months of soaking up the vitamin d from the sun will not protect me thru the winter months............I can't believe the report that says walk from your car to your job and get enough vitamin d, around here, you get wet!! This report also doesn't take into account aftrican american people who have trouble synthesizing enough vitamin d, or obese people who require more vitamin d as the fat cells soak up the vitamin not allowing it into the blood stream. This report maybe fine for those who live in the sunny south, it is not appropriate for those of us who live farther north!! This report also honed in on bone health......there are 700 recepters for vitamin d in our bodies, not just in your bones. I will continue taking my 2000 units a day, have noticed I am much healthier, I also take calcium, twice a day. Really, how am I suppossed to get enough calcium on a 1500 calorie day, which at my size is what I can eat without gaining weight? In the practical world, this study stinks! Thanks for allowing me my say........

Very dissapointing that the "medical" professionals took a tepid step on Vitamin D. They should acknowledge that they nad no basis whatsoever for the previous levels advertised as RDA. I suppose if drug companies were making billions off of Vitamin D it would get a much warmer reception. In fact, its nearly a miracle drug considering all the positive benefits. I take 5000 unit tabs every day and get routine D blood tests to track the blood level which is the only important value. It's well known that older people and overweight people need higher doses also.

My wife and I live on the North Oregon Coast, north of 45 degress of latitude. That means we are closer to the North Pole than the Equator. Most ALL primary care physicans in this part of the United State recommend 20,000 units per week. This is opposed to far less for those who live in southern California or in Haiti. Why? Less sun. We have more days of clouds and rain that those in the sunny climes of this country. The recommendations should be for areas of the country. One size DOES NOT fit all.

It's long been known that vitamin D is essential to maintaining strong bones. But hundreds of new studies have also linked low vitamin D levels to a higher risk of a slew of chronic health problems—heart disease, stroke, diabetes, prostate, breast and colon cancers, auto-immune diseases, infections, depression and cognitive decline. Studies have also suggested that many Americans are vitamin D deficient due to working and playing indoors and slathering on sunscreen.

"Randomized clinical trials have shown that in men and women 60 and older, you see fewer falls and fractures at the 30 ng/ml level," said Bess Dawson-Hughes, endocrinologist and director of the Bone Metabolism Laboratory at Tufts University. She also noted that while healthy people may reach that level taking 800 IUs per day, those who don't go outside, who use sunscreen religiously, have very dark skin or are taking some medications will need more.

Studies have also shown that at levels below 30 ng/ml, the body seeks calcium for everyday needs by leaching it from bones.

I will continue to take my 5000 units daily of Vitamin D. This vitamin plus calcium totally turned my bone density test away from osteopenia and to a normal bone scan in less than a year several years ago and the test is still showing normal. I am at high risk for breast and colon cancer, both of which adequate amounts of Vitamin D have been shown to greatly reduce the incidence of. These so-called experts are not the only experts in this area - many physicians, including Dr. Andrew Weil, disagree with these findings. I will let others listen to this if they must and I will ignore it. Just remember, if many diseases this vitamin reduces the risk for do occur, the drug companies will then make even more money "treating" the disease. They, the drug companies and the physicians (such as oncologists and radiologists) are the ones who don't want the benefits of enough Vitamin D to be too well known. Think about it.

In addition to my post above, being an RN, I am careful what I take and I am totally convinced of the need for this supplement. Again, like someone else wrote, Vit D cannot be patented so It is not a money maker for the drug companies. Think, people! Think!

Let's keep our terminology straight, folks. "Vitamin" D is not a vitamin, it is a hormone precursor. Secondily, for strong bones you need more than Vitamin D and calcium; you also need phosphorus and potasium. Several commentators are correct that "vitamin" D levels can be checked. The issue is complex, and testing may be useful; as always, check with your doctor. Studies done years ago showed that even many "sun bunnies" in S. Calif. had low Vit. D levels. On the flip side, be careful of calcium supplements; many are high in lead because (a) they come from sources that contain a lot of "natural" lead, and/or (b) they come (like most vitamins these days) from the PRC and the quality control is really really poor. [Did I mention that the quality control was really really bad??] There is a lot of balderdash these days floating around about this topic, and so caution is always advisable. [Remember all the hype over Vit. E some years back, and all the uninformed hoopla about antioxidants? (Okay, for those of you that missed the science, oxidation reactions are used by certain white cells to destroy pathogens, among other processes.)] It sounds trite, but some modest supplementation combined with a good diet really gets you what you want. Be careful not to overdue it. Longterm overuse can result in some unfortunate nasty effects.

Science quantify measure specific data
None in this report.
Vitamin D is easily measured.
Vitamin D has a known optimum range 70 to 100.
This is a preventative medicine issue - a well being issue.
This is why we need universal health care - universal well being care.
Just go get a test - if really really low take massive doses per your well being person.
Or if just low perhaps take a little less. Or perhaps take fairly large dose to the reading is about in the range - adjust and repeat annually.

The article and I suspect the report stink if this simple process is not presented.

I feel strongly that the ignorance of physicians on the subject of nutrition and the control of medicine by the pharmaceutical industry is criminal. This morning I heard on CNN that we are getting too much vit D and calcium supplementation. How is this, where is the research? Every patient I see who gets their vit D3 tested is deficient or severely so. The fact that the majority of physicians have never ordered a vit D level, speaks volumes about their lack of knowledge on the subject. They are quick to write prescriptions for fosomax and other drugs for various diseases that require adequate levels of this important secosteroid that is responsible for triggering over 2700 genes. Now the milk and pharmaceutical lobby is using NIH to push back on supplementation. I looked on their website for their research & it was from the mid 90's. The new research states that the majority of the populace is deficient & those with more melanin in their skin, even more so. People, the money's in selling milk & drugs!!! Get you doctor to draw levels of vit D, COQ-10 and the rest of your nutrient levels. That would be blood, urine and stool. Let's get our levels normal before prescribing, so the medicines can work properly with fewer side effects. Doctors, whoes side are you on? Is the patient's or big pharma??? Remember your "oath"!!!

Reply to Delantero: Not everyone can take advantage of the sun. I would live in the sun, but even a short time in the sun does not mix well with one of the prescriptions I take. This reaction causes me to break out in sores. You should have considered that possibility before jumping out there. I take 3000 units of Vit D a day, and I can't tell you how much better I feel. When I was younger and a sun worshiper, I don't recall the lift I feel now; however, I did look good. Another driving fact is Doctors are finding out vit D levels are low in elderly people who are suffering mental diseases. That's all the motivation I need.

Well, vitamin D deficiency has become almost trendy these days, and there's always a danger in that. People here about it and decide it's going to cure all their woes and start triple dosing themselves. Even doctors aren't immune to the trend, going along to placate patients. Every few years something new is hyped, everyone gets stirred up about it, and next thing you know we have a whole new rash of problems because we are an obsessive culture and have trouble grasping the concept of moderation.

Many people probably don't get sufficient sun. When is the last time you saw your neighbors outside? And it's a fact that as we age our bodies don't process things as efficiently.

Overall, I think the new recommendations are probably a good thing. Vitamin D is not a cure all. It is possible to overdose, and do great harm. Overdosing can have serious side effect. We need to stop rushing over the cliff like lemmings.

Good to see so many of the commenters not taking this seriously. This article is hilariously funny... BREAKING NEWS! -- THE WORLD MUST INCREASE ITS DAILY INTAKE OF VITAMIN D OR SUFFER SERIOUS CONSEQUENCES! AND MAKE SURE YOUR MEASUREMENTS ARE CORRECT OR YOU COULD SUFFER A THOUSAND LIFE-THREATENING MALADIES, INCLUDING PERMANENT BRAIN DAMAGE!... Almost enough to make me renounce my liberal leanings and convert to good old fashioned ignorant conservatism!

Posted by: flynnct
I missed this great series of studies on overdosing on Vit D
~~~~~~

Seriously? Google Vitamin D overdose and you'll get all the information your heart desires. But for a quick summary, vitamin D overdosing symptoms include vomiting, weakness, renal failure ... and those are just the easily pronouncable ones. Most of it you can come back from by decreasing the dosage, but if you damage your kidneys, it may be permanent.

cb11 | November 30, 2010 4:26 PM
Seriously? Google Vitamin D overdose
The research you suggested does confirm that Vit D overdose can occur - about as frequently as abuse of to much water - also a rare event bot one that does occur.
An overdose by taking from 10,000 to 40,000 daily for an extended time will never occur wit amounts reasonably discussed in the above discussions and never in the presented protocol of measure, take Vit D, re measure.
Discussing overdosing with Vit D in a conversation discussing whether it is reasonable to take 4,000 or 5,000 IU in lieu of a "600 international units a day met the need" is verging on an Argument From Small Numbers, eg because it can happen it is important.

Certainly more research is needed on this topic, before increasing your intake of Vitamin D, better to consult your doctor 1st because not everyone is suitable to have a higher than usual dosage of Vitamin D. Generally, it is better to aim for moderate amount. To stay healthy, a balanced diet is equally important. http://sextisfaction.wordpress.com

This article is BS. I take 5000 IU a day of Vit D in northern NY and I feel much much better since I have upped my intake. I am never sick and haven't been in 5 years since taking my vit D. No flu, bug, cold... nothing.

This is an advertisement for the Milk industry because in reality, MILK does not give you any vit D. In reality, milk does the opposite and sucks the Vit D out of your system. Of course, the research is hidden from everyone.

Its already been proven that todays food provides less than HALF the nutrients our fathers and grandfathers received from their food. That means, supplementation is a MUST, especially for children. If you're not taking a good multi, greens, and other nutrients, you are a fool.

And as for staying out of the sun, i highly recommend it. The Ozone is in horrible shape and as we head towards 2012 the suns activity will be heating up which means more harmful rays will be hitting you while you are outside. Be careful.

I have multiple sclerosis. My neurologist has me taking a weekly 50000 IU Vitamin D supplement. His thought is that improving my deficiency will help me fight against some of the effects of my condition.

Anyone can go overboard on vitamin and mineral supplements, but I decided years ago that most of my patients at the nursing home were there because of an accumulation of vitamin deficiencies. A person usually eats the very same varieties of food in his diet his entire life. It stands to reason that by the time he is up in age, all the vitamins he was missing because he never ate certain foods accumulate quite a BIG deficiency that affects his bones, hs heart, his mind, his G.I. system, etc. I started taking vitamins and minerals with good sense and independent guidance, and I've NEVER regretted it. I can still pass for a 50 year old, and I am almost 71!

I don't guess, I test. And vitamin D tests are cheap through the LEF (they use LabCorp; about $63 per test for non-members). On 11/30/09, my 25-hyroxy vitamin D level was 28.9 ng/ml, so I started to take 1000 IU/day. By 06/29/10, it had only gone up to 29.9 ng/ml, so I started taking 2x2000IU/day, along with a teaspoon of cod liver oil. On 11/22/10, my level had only gone up to 31.3 ng/ml, still lower than optimal. So even 28,000 IU/week is not enough for some people.

Or you can buy the test at discount lab sites for the same or less (www.directlabs.com). Although I generally recommend a comprehensive blood chemistry to ensure other nutrients are at normal as well.

Use D3 (not D2), take D3 with food (it needs fat to cross the intestinal wall), and you may have to take a brief large dose (50,000 iu/day for 8 days) to overcome substrate starvation (Holick). If levels still don't rise, then have to assess co-factors (magnesium, zinc, vitamin K2, boron, vitamin A).

1. The NAS IOM FNB is a scientist-for-rent org. The study sponsors (USDA et al) set the parameters within their Area of Responsibility and mission.
2. The USDA is focused on foods (sunshine isn't in their mission), menu planning, school lunches, fortified foods, etc. The DRI are only a few nutrients in the entire nutrient chain. The USDA and the FNB do not set healthcare or medical policy or treatment standards.
3. Their paradigm is focused on the isolated variable; how much calcium does a bone need? They do not ask the question:"What does the bone system need to be healthy and strong?" Bones do more than act as meat hangers. Bones need exercise, 20+ nutrients, and an alkaline serum balance to be healthy. They would not mention smoking as a major bone threat.
4. It is better to focus on strategic organizational changes:
a. Set optimum serum levels in balance as the primary objective.
b. Set the Best Technical measurement standard. Some docs are still not using the 25(OH)D3 test.
c. Set recommended food, lifestyle, etc. changes/intakes with appropriate caveats/risk factors (which may not fit on the vitamin bottle or milk carton).
d. De-link intake/exposure standards from menu planning, school lunches, and fortified foods where necessary. For example, if most need 2,000 iu D3/day, do you really want to put 2,000 iu in all milk? Or given latitude variations, might you want the milk standard to vary by latitude? The system needs more flexibility & tailoring.

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